{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T22:14:19Z","timestamp":1773872059911,"version":"3.50.1"},"reference-count":44,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004543","name":"Chinese Scholarship Council","doi-asserted-by":"crossref","award":["202308080110"],"award-info":[{"award-number":["202308080110"]}],"id":[{"id":"10.13039\/501100004543","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100018693","name":"HyFiDress consortium","doi-asserted-by":"publisher","award":["101159615"],"award-info":[{"award-number":["101159615"]}],"id":[{"id":"10.13039\/100018693","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: Antibiotic-loaded bone cement (ALBC) is widely used for local antibiotic delivery in joint arthroplasty to prevent and treat prosthetic joint infections (PJIs). In this study, we evaluated the efficacy of cemented Kirschner (K)-wires coated with various ALBC formulations using a Galleria mellonella infection model against multidrug-resistant (MDR) Staphylococcus aureus and Enterococcus faecalis. Methods: We tested commercially available bone cements, including gentamicin-only formulations (PALACOS R+G) and dual-antibiotic formulations, combining gentamicin with either clindamycin (COPAL G+C) or vancomycin (COPAL G+V), alongside an antibiotic-free control (PALACOS R). In vitro assays\u2014including minimum inhibitory\/bactericidal concentration (MIC\/MBC) determination, antibiotic release kinetics, agar diffusion, and antibiofilm evaluations\u2014demonstrated effective antibiotic release and significant antimicrobial activity against both planktonic and biofilm-associated bacteria. Results: In vivo, ALBC-coated K-wires were well tolerated in G. mellonella and significantly protected the larvae from S. aureus infection compared to controls. Notably, dual-antibiotic formulations provided superior protection, correlating with substantial reductions in bacterial colonisation on implant surfaces and in surrounding tissues. Conclusions: These findings support the utility of the G. mellonella model as a high-throughput, cost-effective platform for the preclinical evaluation of antimicrobial strategies to prevent and treat PJIs and further demonstrate the effectiveness of dual-loaded ALBC against multidrug-resistant bacteria.<\/jats:p>","DOI":"10.3390\/antibiotics14121280","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T10:41:23Z","timestamp":1765968083000},"page":"1280","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy of Dual-Antibiotic-Loaded Bone Cement Against Multi-Drug-Resistant Staphylococcus aureus and Enterococcus faecalis in a Galleria mellonella Model of Periprosthetic Joint Infection"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0365-7748","authenticated-orcid":false,"given":"You","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Trauma Surgery, University Hospital Regensburg, Franz-Josef-Strau\u00df-Allee 11, 93053 Regensburg, Germany"},{"name":"Department of Orthopaedic Surgery, The People\u2019s Hospital of Hechi, Hechi 547000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9984-5657","authenticated-orcid":false,"given":"Gopala Krishna","family":"Mannala","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, University Hospital Regensburg, Franz-Josef-Strau\u00df-Allee 11, 93053 Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3594-8478","authenticated-orcid":false,"given":"Rapha\u00eblle","family":"Youf","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, University Hospital Regensburg, Franz-Josef-Strau\u00df-Allee 11, 93053 Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9351-599X","authenticated-orcid":false,"given":"Martina","family":"Humez","sequence":"additional","affiliation":[{"name":"Institute of Microbiology and Molecular Biology, Justus-Liebig-Universit\u00e4t Giessen, Heinrich-Buff-Ring 26, 35392 Giessen, Germany"},{"name":"Heraeus Medical GmbH, Philipp-Reis-Str. 8-13, 61273 Wehrheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth","family":"Schewior","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, University Hospital Regensburg, Franz-Josef-Strau\u00df-Allee 11, 93053 Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus-Dieter","family":"K\u00fchn","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0208-4650","authenticated-orcid":false,"given":"Volker","family":"Alt","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, University Hospital Regensburg, Franz-Josef-Strau\u00df-Allee 11, 93053 Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5444-3179","authenticated-orcid":false,"given":"Martijn","family":"Riool","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, University Hospital Regensburg, Franz-Josef-Strau\u00df-Allee 11, 93053 Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"101152","DOI":"10.1016\/j.artd.2023.101152","article-title":"Projections and Epidemiology of Revision Hip and Knee Arthroplasty in the United States to 2040\u20132060","volume":"21","author":"Shichman","year":"2023","journal-title":"Arthroplast. 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